Atherosclerosis and Coronary Artery Disease

Atherosclerosis -- sometimes called hardening of the arteries -- can slowly narrow the arteries throughout your body.

When atherosclerosis affects arteries that carry blood to the heart muscle, it’s called coronary artery disease. That’s the No. 1 killer of Americans. Most of those deaths are from heart attacks caused by blood clots.

Atherosclerosis can create life-threatening blockages -- without you ever feeling a thing. Since we’re all at risk for coronary artery disease, it’s worth learning more about atherosclerosis.

Cold Facts About Hard Arteries


  • More than 90,000,000 Americans have known cardiovascular disease.
  • Almost 800,000 people in the U.S. have a heart attack each year.
  • Around 500,000 people will die Almost 800,000 people in the US have a of coronary artery disease this year. More than a million will have a heart attack about 115,000 of them will die from it. 
  • About one in 7 deaths in the US is caused by Coronary Heart Disease.  About 360,000 people will die from it each year.
  • Half of all men who have severe atherosclerosis with no symptoms.
  • More men than women die from coronary artery disease. The rates for women go up after menopause, but they never catch up with men's.
  • Heart disease is the No. 1 killer in women, just as in men.



Many of us have heard that clogged arteries lead to heart attacks. But how does atherosclerosis cause coronary artery disease?

First, the coronary arteries’ smooth interior surface is damaged. High blood pressure, abnormal cholesterol levels, cigarette smoking, and diabetes are the most common reasons why.

LDL -- or "bad" cholesterol -- then starts to build up in the coronary artery’s wall. The body sends a "clean-up crew" of white blood cells and other cells to the toxic site.

Over years, continuing buildup of cholesterol and the body’s response to it create a plaque. That’s a bump on the artery wall that can obstruct blood flow.

Plaques’ Sneak Attacks

Atherosclerosis plaques in the coronary arteries can behave in several ways:

They can grow slowly, never blocking the artery or causing clots.


They can expand and block blood flow in a coronary artery. This may cause no symptoms, even when the artery is very blocked.

Other times, a blockage does cause symptoms. Called “stable angina,” this is most commonly chest pain with activity. It goes away with rest. It’s not a heart attack.

A plaque can rupture. That causes blood to clot quickly inside the coronary artery.

A plaque rupture is as terrible as it sounds. The result is a blood clot that makes your chest hurt.

Two things can happen then:

Unstable angina: The clot doesn't totally block the blood vessel. It then dissolves without causing a heart attack.

Heart attack (myocardial infarction): The coronary artery is blocked by the clot. Heart muscle, starved for nutrients and oxygen, dies.

Blood clots can form in any of the arteries of the heart, even those with only minor blockages.

Reduce Your Risk of Coronary Artery Disease

No one can predict who will have a heart attack. But coronary artery disease isn’t random. Most people with coronary artery disease have one or more controllable risk factors.

Most people who have a heart attack will have at least one or more of the following risk factors. These all can contribute to atherosclerosis and coronary artery disease. They are also the causes of coronary artery disease:

Most of us have plenty of room for improvement.

The best way to determine your risk level is to see your doctor. But you can start to reduce your risk today. Eat right, don’t smoke, and exercise. Remember to check with your doctor before starting a new exercise plan.

Some people may also need to take medicine to keep their cholesterol and blood pressure in a healthy range.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on January 05, 2018



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Mark Silverman, MD, emeritus professor of medicine, Emory University School of Medicine, chief of cardiology, Piedmont Hospital, Atlanta.

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